| Lookout Mountain Community Services | |
|
200 N Etowah Ln Canton GA 30114-2378 | |
| (770) 479-1524 | |
| Not Available |
| Full Name | Lookout Mountain Community Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 200 N Etowah Ln, Canton, Georgia |
| Authorized Official Name and Position | Alicia Michelle Howard (CREDENTIALING) |
| Authorized Official Contact | 7066701080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lookout Mountain Community Services Po Box 1027 La Fayette GA 30728-1027 Ph: (706) 638-5580 | Lookout Mountain Community Services 200 N Etowah Ln Canton GA 30114-2378 Ph: (770) 479-1524 |
| NPI Number | 1245404839 |
|---|---|
| Provider Enumeration Date | 04/15/2008 |
| Last Update Date | 02/10/2023 |
| Certification Date | 02/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245404839 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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